Individual
NIKETA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
106 W BARTLETT AVE, BARTLETT, IL 60103-7880
(630) 830-4930
Mailing address
1745 N CLYBOURN AVE, APT 2S, CHICAGO, IL 60614-8991
(630) 344-3551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030445
IL
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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